RHO: Reproductive Health Outlook

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Table 7. Hard-to-Reach Adolescent Groups

Adolescent Group


For additional information

Live or work on the street

- At high risk of HIV/STIs, unintended pregnancy, sexual exploitation, violence, and substance abuse
- Often have weak family and social ties
- May have to work long hours
- Need basic information about reproductive health
- May need shelter or legal advocacy

Filgueiras, 1993;
Malamud, 1995;
Stevens, 1999;
WHO Fact Sheet, 1997

Sexually abused or exploited

- Vulnerable to HIV/STIs, unintended pregnancy, physical violence
-Sexual abuse in childhood is associated with risk-taking behaviors. These adolescents need access to counseling services, especially services that address self-esteem and assertiveness skills.
- May need community support and legal services

IRCW, 1996;
Shanler, 1998

Indigenous groups

- Face obstacles to schooling and health education, including language, cultural, and geographic barriers
- May require services that include separate hours and bilingual or indigenous staff

Farell, 1999

Young married couples

- May be overlooked by programs that focus on older women, or in societies that expect women to demonstrate their fertility soon after marriage.
- Often experience unplanned pregnancy
- Need access to contraception and information about time of pregnancy risk during menstrual cycle

Alauddin and MacLaren, 1999

Young men

- Generally have more sexual partners and experiences than women of same age, but have less information
- May require specialized services to learn about male and female reproductive health, pregnancy, STIs, and contraception

Boyd and Moore, 1998;
RHO's Men and Reproductive Health section

Refugees and displaced adolescents

- Often have experienced rape, violence, or death of family members
- May be malnourished or affected by disease
- Available reproductive health services may be limited to caring for pregnant women or septic abortions; this group needs basic reproductive health and general health information.
- Need access to contraception, especially ECPs

Barnett, 1995

Gay youth

- May be subjected to harassment and violence
- Fear rejection and isolation; need a supportive environment
- Need information about risk behavior, correct use of condoms, and HIV

Ryan and Futterman, 1997

Youth with disabilities

- May receive less information about sexuality, reproduction, contraception, and prevention of STIs
- May be socially isolated, less able to learn from peers
- Selection of contraceptive method must take relevant physical or mental impairment into consideration. Some medical treatments, for example, may interfere with hormonal contraception or cause teratogenic effects.

Blum, 1997

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Copyright 1997-2002, PATH.

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